• Worldwide Revenue: $49 million in Q4 2024, growth exceeding 26%.
• US Revenue: $46.9 million in Q4 2024, 28% growth.
• International Revenue: $2.1 million in Q4 2024.
• Full Year 2024 Revenue: $167.2 million, over 20% growth.
• Gross Profit: $38.8 million in Q4 2024, 35% increase.
• Gross Margin: 79% for both Q4 and full year 2024.
• Operating Expenses: $44.3 million in Q4 2024, 8% growth.
• Net Loss: $4.5 million in Q4 2024, improved by nearly 60%.
• Adjusted EBITDA: $1.9 million in Q4 2024, compared to a loss of $4.8 million in Q4 2023.
• Cash and Marketable Securities: $150 million at the end of 2024.
• 2025 Revenue Guidance: $193.5 million to $195.5 million, 16% to 17% growth.
• 2025 Gross Margin Guidance: Expected between 77% and 78%.

• Warning! GuruFocus has detected 7 Warning Signs with SIBN.

Release Date: February 24, 2025

For the complete transcript of the earnings call, please refer to the full earnings call transcript.

Positive Points

• SI-BONE Inc (NASDAQ:SIBN) reported a record $49 million in worldwide revenue for Q4 2024, representing over 26% growth.
• U.S. revenue increased by 28% to $46.9 million, driven by strong demand from nearly 1,400 active physicians.
• The company achieved positive adjusted EBITDA in Q4 2024 and expects to maintain this for the full year 2025.
• SI-BONE Inc (NASDAQ:SIBN) has successfully launched new products like Granite 9.5 and TNT, which have exceeded adoption expectations.
• The company has a strong liquidity position with $150 million in cash and marketable securities, and is focused on achieving positive free cash flow.

Negative Points

• SI-BONE Inc (NASDAQ:SIBN) faces risks related to maintaining favorable reimbursement for its products and procedures.
• There is potential economic weakness that could impact patients' ability and desire to undergo elective procedures.
• The company is involved in an ongoing DOJ investigation, which could pose legal and reputational risks.
• Guidance for 2025 revenue growth is slightly lower at 16% to 17%, compared to previous years' higher growth rates.
• Gross margins are expected to decline slightly in 2025 due to factors like procedure mix and increased depreciation.

Q & A Highlights

Q: Can you discuss the growth drivers for SI-BONE in 2024 and expectations for 2025? A: Laura Francis, CEO, highlighted that the growth in 2024 was driven by strong demand across all procedure types and call points, including SI joint fusion, Granite 9.5, and TNT. The company expects these growth drivers to strengthen in 2025 due to product launches in 2024, positioning SI-BONE for continued top-tier med tech revenue growth.

Q: Why is the 2025 revenue growth guidance of 16% to 17% lower than previous years? A: Anshul Maheshwari, CFO, explained that while the company is optimistic about 2025, they have taken a balanced approach to guidance. Factors such as potential reimbursement tailwinds, procedure mix impacts on ASP, and one less procedure day have been considered. The company remains confident in capitalizing on demand throughout the year.

Q: How is SI-BONE positioned in the competitive landscape, particularly with potential disruptions in the spine market? A: Laura Francis, CEO, stated that SI-BONE remains the market leader in SI joint fusion, supported by a comprehensive product portfolio and strong educational and advocacy infrastructure. The company continues to compete effectively and sees its recent product launches as a foundation for future growth.

Q: What are the expectations for gross margins in 2025, and how do they compare to previous years? A: Anshul Maheshwari, CFO, noted that the expected gross margin for 2025 is 77% to 78%, slightly lower than 2024 due to factors like ASP impacts from procedure mix and increased depreciation from new surgical capacity. However, the company is working on initiatives to offset these pressures and maintain strong margins.

Q: Can you provide an update on the DOJ investigation and any changes to company practices? A: Laura Francis, CEO, mentioned that SI-BONE is cooperating with the DOJ transparently and has a strong compliance program in place. The investigation focuses on field-based education events and physician remuneration. The company will update investors as material information becomes available.

For the complete transcript of the earnings call, please refer to the full earnings call transcript.